Vulnerability to epidemic malaria in the highlands of Lake Victoria basin: the role of climate change/variability, hydrology and socio-economic factors

Abstract

Endemic malaria in most of the hot and humid African climates is the leading cause of morbidity and mortality. In the last twenty or so years the incidence of malaria has been aggravated by the resurgence of highland malaria epidemics which hitherto had been rare. A close association between malaria epidemics and climate variability has been reported but not universally accepted. Similarly, the relationship between climate variability, intensity of disease mortality and morbidity coupled with socio-economic factors has been mooted. Analyses of past climate (temperature and precipitation), hydrological and health data , and socio-economics status of communities from the East African highlands confirm the link between climate variability and the incidence and severity of malaria epidemics. The communities in the highlands that have had less exposure to malaria are more vulnerable than their counterparts in the lowlands due to lack of clinical immunity. However, the vulnerability of human health to climate variability is influenced by the coping and adaptive capacities of an individual or community. Surveys conducted among three communities in the East African highlands reveal that the interplay of poverty and other socio-economic variables have intensified the vulnerability of these communities to the impacts of malaria.

Modelling homogeneous regions of social vulnerability to malaria in Rwanda

“…Since previous exposure to malaria infection is required, immunity fails to develop in high altitude zones where malaria transmission is limited by low temperature. Thus, highland communities which are less exposed to mosquito bites would be more vulnerable to malaria infection than their counterparts in lowlands (Wandiga et al, 2010). In the lowlands where transmission intensity is high, the acquired immunity of people may be lost with an interruption to parasite exposure as result of seasonal malaria transmission, intensive interventions with insecticide, treated bed nets, or extended travel out of an endemic area (Baird, 1995).…”

Vulnerability to the health effects of climate variability in rural southwestern Uganda

“…Malaria was interpreted in reference to a multitude of clinical symptoms and spiritual manifestations. This wide range of understandings is reported as a common challenge for identification of malaria using self-reporting of malaria symptoms and is influenced by culture, education, and economic factors (Appiah-Darkwah and Badu-Nyarko 2011; Wandiga et al 2010;Elmardi et al 2011).…”

Implications for health education and intervention strategies arising from children's caregivers concerns following successful malaria control

“…Malaria, poverty, and economic development go hand in hand. 4 Therefore, a centralized, communitypassive, malaria control system (such as IRS with associated support mechanisms) may afford poor communities with a more reliable buffer of safety from climate change, 30 and perhaps also from economic upheavals. This also implies that until such time that an effective alternative to DDT is freely available, all possible preventative measures must be taken by both spray-workers and residents to limit any unwarranted exposures.…”